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Corticosteroid eyedrops induced blepharoptosis and atrophy of levator muscle

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The purpose of the study is to analyze the incidence, manifestations, and treatment of blepharoptosis caused by long-term use of corticosteroid eyedrops.


Retrospective case series include 46 patients with a history of using corticosteroid eyedrops unilaterally for at least 2 months. The palpebral fissure, MRD1, and levator function were evaluated.


Among 46 patients, the differences of mean MRD1 (p < 0.0005), palpebral fissure height (p < 0.0005), and levator function (p = 0.003) between eyes with and without corticosteroid eyedrops application were significant. Ptosis existed in 40 out of 46 eyes with corticosteroid; the differences of the mean MRD1 (p < 0.0005) and palpebral fissure height (p = 0.001) between eyes with and without ptosis were significant. Nine patients underwent levator aponeurosis repair surgeries. Pathological examinations revealed mainly vascular fibers and few muscle fibers, as well as apoptosis of levator palpebrae muscle and Muller muscle.


Blepharoptosis is frequently observed after chronic corticosteroid eyedrops use in Chinese population.

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This study was funded by the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2018PT32029).

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Correspondence to Xiao-wei Liu.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Procedures performed in this study were in accordance with the ethical standards of the Peking union medical college hospital and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Zhang, X., Zhang, M., Zhao, D. et al. Corticosteroid eyedrops induced blepharoptosis and atrophy of levator muscle. Graefes Arch Clin Exp Ophthalmol (2020). https://doi.org/10.1007/s00417-020-04622-x

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  • Corticosteroid eyedrops
  • Uveitis
  • Blepharoptosis
  • Atrophy of levator muscle
  • Palpebral fissure
  • Margin reflex distance
  • Levator function